ABA Advanced Keywords Flashcards
statistical test that compares categorical data; labels rather than numbers
Chi square
statistical test that compares 3 or more means
ANOVA
statistical test that compares 2 means of same study subjects at 2 different different times
paired t-test
statistical test that compares 2 means of 2 different study subject groups
unpaired t-test
statistical test that compares 2 means
t-test
musculocutaneous: motor
arm flexion
musculocutaneous: sensory
lateral forearm
median nerve: motor
lateral deviation of wrist, grip of thumb/index/middle finger
median nerve: sensory
medial palm, including thumb/index/middle fingers
ulnar nerve: motor
medial deviation of wrist, grip of 4th/5th digits
ulnar nerve: sensory
lateral aspect of hand including 4th/5th digits
radial nerve: motor
arm/wrist extension
radial nerve: sensory
extensor surfaces of arm/hand
initial dose of dantrolene for MH
2.5 mg/kg
causes of increased SID
- dehydration
- chloride loss (aggressive NG sxn)
- “increase in unmeasured ions”
causes of decreased SID
- free water excess
- excessive normal saline
- severe diarrhea
- lactic acidosis, DKA
components of qSOFA score
- RR > 22
- AMS
- SBP < 100
TEG: treatment for prolonged R
FFP
TEG: treatment for prolonged K
cryo
TEG: treatment for decreased MA
platelets
TEG: treatment for teardrop configuration
antifibrinolytics
amount and pressure of full O2 tank
700 L at 2,200 psi
amount and pressure of full nitrous tank
1,590 L at 750 psi
-constant psi until 3/4 empty, so doesn’t start falling until <400L gas remain
How do you know how much nitrous is left?
must weigh cylinder
lab values associated with hyperparathyroidism
non-anion gap metabolic acidosis
- hyperchloremia
- renal bicarb loss (low bicarb on labs)
- high Ca
effect on oxyHgb dissoc. curve: alkalosis
curve shifts left (tighter)
effect on oxyHgb dissoc. curve: hypothermia
curve shifts left (tighter)
effect on oxyHgb dissoc. curve: decreased 2,3-DPG
curve shifts left (tighter)
effect on oxyHgb dissoc. curve: carboxyHgb
curve shifts left (tighter)
effect on oxyHgb dissoc. curve: methemoglobin
curve shifts left (tighter)
effect on oxyHgb dissoc. curve: acidosis
curve shifts right (offloads easier)
effect on oxyHgb dissoc. curve: hyperthermia
curve shifts right (offloads easier)
effect on oxyHgb dissoc. curve: fetal Hgb
curve shifts left (tighter)
effect on oxyHgb dissoc. curve: increased 2,3-DPG
curve shifts right (offloads easier)
effect on oxyHgb dissoc. curve: hypercarbia
curve shifts right (offloads easier)
morphine equivalents: intrathecal to epidural
1 mg intrathecal = 10 mg epidural
morphine equivalents: epidural to IV
1 mg epidural = 10 mg IV
morphine equivalents: IV to PO
1 mg IV = 3 mg PO
hemophilia A affects factor __
hemophilia A = factor VIII
hemophilia B affects factor __
hemophilia B = factor IX
name the four predictors of MG postop resp failure
- dz duration > 6 yrs
- pyridostigmine daily dose > 750 mg
- FVC < 2.9
- other chronic lung dz
LAD:
- what part of heart affected
- what leads affected
- anterior, anteroseptal
- leads V1-6
LCx:
- what part of heart affected
- what leads affected
- lateral, posterior wall
- leads 1, AVL, V5-6
RCA:
- what part of heart affected
- what leads affected
- inferior, midseptal
- leads II, III, AVF
harsh systolic murmur heard using diaphragm at 2nd/3rd intercostal space when pt is supine; may disappear during inspiration
pulmonic stenosis
low holosystolic or mid-systolic decrescendo murmur heard during inspiration with diaphragm at L sternal border at 3rd interspace
tricuspid regurg
continuous machine-like murmur heard best at L upper sternal border
PDA
low-pitched diastolic rumble best heard over PMI during exhalation
mitral stenosis
blowing pan diastolic murmur heard best at L/R sternal borders at 3rd/4th intercostal interspace while pt sitting up and leaning forward; use diaphragm
aortic regurg
harsh systolic ejection murmur, can radiate to carotids
aortic stenosis
CRPS associated with previous minor injury
CRPS I
CRPS associated with previous nerve injury
CRPS II
borders of femoral triangle
superior = inguinal ligament medial = adductor longus lateral = sartorius (if sartorius twitch only, move needle laterally)
where do most myxomas arise from
left atrium (70%)
pacer indications
- second degree type II AV block
- third degree block
- symptomatic brady
- refractory SVT
CVP waveform: loss of a wave
afib
CVP waveform: canon a wave
AV dissociation
CVP waveform: tall c and v waves, loss of x descent
tricuspid regurg
CVP waveform: tall a and v waves, minimal y descent
tricuspid stenosis
CVP waveform: tall a and v waves, steep x and y descent, M or W config
RV ischemia, pericardial constriction
CVP waveform: exaggerated X descent, attenuated y descent
tamponade
best lead for detecting P waves, arrhythmias
lead II
most sensitive lead for MI detection
V4
minimum inflation of tourniquet
systolic + 50
lab changes after 3 days at high altitude
- resp alkalosis
- PaO2 50-65
- bicarb loss in CSF after 2-4 days
local anes administration: order of most to least systemic absorption
IV > tracheal > intercostal > caudal > epi > brachial plexus > femoral/sciatic > subQ
What reverses dabigatran (NOAC)?
idarucizumab
Name the 3 nerve blocks/locations required for awake intubation
- glossopharyngeal = palatoglossal folds
- superior laryngeal = injection at horn of hyoid, or pledget in pyriform sinus
- recurrent laryngeal = transtracheal injection
possible causes of increased peak pressure, normal plateau pressure
kinking
plugging
bronchospasm
possible causes of increased peak pressure, increased plateau pressure
tension pneumo atelectasis pulm edema pneumonia bronchial intubation
causes/indications of distributive shock
due to decreased SVR: septic shock, anaphylaxis, neurogenic shock
- usually decreased CVP, decreased or normal CO, increased PAOP
what two drugs can improve SSEPs
- etomidate
2. ketamine
what’s the main problem with hydroxyethyl starches
coagulopathy:
- dilution
- reduced factor VIII, vWF
- reduced glycoprotein IIb/IIIa
labs seen with hyperaldosteronism
high Na, low K, reduced renin
-tx: cortisol, K repletion
EKG findings with hypoK
- prolonged PR interval, incr P wave amplitude
- ST depression
- T wave flattening/inversion
- prominent U waves
lung resection postop resp risk assessment components and cutoffs
- O2 usage: VO2 max > 15 mL/kg/min
- spirometry: predicted postop FEV1 < 30%
- O2 delivery: DLCO < 40%
If lung resection postop resp risk assessment doesn’t meet criteria, what can you do?
consider split function testing (to see which lung contributes more)
- occlusion of PA to lung being resected must result in PAs < 35 or PaO2 > 45
issues with old blood after storage
- excess H+, K+
- progressively less 2,3-DPG, so has less O2-releasing capacity
main mechanism of acupuncture analgesia (in theory)
stimulation of type I/II afferent nerves or A-delta fibers in muscles => send impulses to anterolateral tract of cord => release of enkephalin, dynorphin
- prevents pain messages from ascending in spinothalamic tract
What are the 3 types of von Willebrand dz? Anything special about them?
types 1-3, with 3 being worst (total deficiency; recessive)
type 2b: desmopressin will cause drop in plts, so use factor concentrate to tx preop instead
treatment for cyanide tox
1st. hydroxycobalamin (FIRST), then
- sodium thiosulfate (sulfur donor; can excrete via kidneys)
- amyl nitrate: converts Hgb => metHgb that binds CN
- bicarb to help with acidosis
lab values with cyanide tox
- anion gap metabolic acidosis
- increased PaO2, SvO2 (can’t use the O2 present)
What can happen with high dose NTP
cyanide tox:
- normal ferrous (Fe2+) iron in RBCs => ferric (Fe3+)
- SNP becomes unstable with extra electron, so breaks into 5 CN- molecules
- inactivates cytochrome oxidase => stops oxidative phosphorylation (so you’re in anaerobic resp)
Indications for dialysis
Acidemia Electrolytes Ingestions Overload Uremia
Name some conditions that cause reduced FRC
Pregnancy Ascites, Advanced age Neonates GA Obesity Supine
What issue does echothiophate cause?
inhibits butyrylcholinesterase
- sux lasts longer
What happens to MAC at advanced age?
after age 40, MAC decreases 6% per decade
initial treatment of airway fire
First: extubate + stop flow of gases at same time
- remove flammable materials from airway
- saline in airway
Tx for long QT syndrome issues
- IV mag
- replace K, Ca
- avoid amiodarone
umbilical _______ gas: assesses maternal side
umbilical _______ gas: assesses fetal side
umbilical venous = assesses maternal side
umbilical arterial gas = assesses fetal side
what happens to protein C in pregnancy
(c)resistance to protein C
what happens to protein S in pregnancy
decreaSsssssed level of protein S
What factors increase with pregnancy?
Hypercoagulable, so decreased PT/APTT
- fibrinogen
- factors VII, IX, X, XII, vWF
What factors decrease with pregnancy?
- factor XI
- factor XIII
- antithrombin 3
- tPA
What are the four parts of SIRS
- temp >38 or <36
- HR > 90
- RR > 20 or PaCO2 < 32
- WBC > 12,000 or < 4,000
What pulm measurements are generally unchanged in elderly?
- TLC
2. PaCO2
most common bugs associated with later VAP
late VAP is > 72 hrs after tubing = more virulent
- MRSA
- Pseudomonas
- Acinetobacter
Name some risk factors for VAP
- paralytics
- witnessed aspiration
- enteral feeding
- prolonged intubation
- extremes of age
What’s the WHO analgesic ladder for cancer pain?
- non opioid +/- adjuvant
- weak opioid for mild/mod pain (tramadol, codeine)
- strong opioid for moderate/severe pain
What’s the point of the Cochrane collaboration?
conducts systematic reviews and meta-analyses of healthcare interventions/diagnostic tests
What does it mean to quench MRI?
loss of superconductivity + release of He gas
- MCC: intentional shutdown for life-threatening emergency
- if tube is blocked/disconnected, lethal amts of helium can escape into scanner
What metals are safe for MRI?
- aluminum
- brass
What nerves are covered with popliteal block, and what is your goal?
tibial > common peroneal
- tibial: plantar flexion, inversion
- peroneal: dorsiflexion, foot eversion
If doing a pop block and get foot eversion, what do you do?
redirect medial (you’re getting common peroneal instead)
If doing a pop block and get foot semimembranosus twitch, what do you do?
redirect lateral
If doing a pop block and get local biceps femoris twitch, what do you do?
redirect medial
____: can be missed in axillary block, but can supplement medial to brachial artery in antecubital fossa
median nerve
_____: runs lateral to biceps tendon in antecubital fossa
radial nerve
SSEPs monitor what part of spinal cord?
Dorsal columns
MEPs monitor what part of spinal cord?
Corticospinal tract
____ = primary determinant of local anesthetic potency
lipid solubility
____ = primary determinant of speed of onset of local anesthetic
pKa
What does higher frequency ultrasound probe mean in terms of:
- resolution
- depth
higher frequency probe = lower resolution, deeper penetration
What happens to K+ for each 0.1 decrease in pH?
plasma K+ increases by 0.6
Formula for how many mEq sodium are needed to correct a deficit
Na+ dose = weight * 0.6 * (desired # - actual #)
safe dose of epi per kg
5 mcg/kg
What can you use in pts that need to go on bypass but have HIT type II (immune)?
Hirudin, bivalirudin
What’s the p50 for normal adult Hgb?
25 mm Hg
MOA argatroban
direct thrombin inhibitor
MOA -irudins
direct thrombin inhibitors
MOA abciximab
glycoprotein IIb/IIIa inhibitors
MOA eptifibatide
glycoprotein IIb/IIIa inhibitors
MOA tirofiban
glycoprotein IIb/IIIa inhibitors
MOA fondaparinux
anti-Xa antagonist
MOA -xabans (apixaban, rivaroxaban)
anti-Xa antagonist (factor Xa inhibitors)
Alpha-1 receptor activity
Mydriasis BronchoC VasoC Uterine ctx GI/GU sphincter ctx Inhibition of insulin secretion and lipolysis \+inotrope
What adrenergic Rs are in the heart?
Alpha-1 Rs
Beta-1 Rs
What do alpha-2 Rs do?
Inhibits adenylyl cyclase
At CNS level:
Sedation
Reduced sympathetic outflow
Peripheral vasoD
What does stimulation of Beta-1 Rs do?
+chronotrope
+dromotrope
+inotrope
What does stimulation of beta-2 Rs do?
BronchoD
VasoD
Uterine relax
Insulin release, lipolysis, glycogenolysis, gluconeogenesis
Basically opposite of alpha-1 stimulation
MOA dabigatran
direct thrombin inhibitor
